CT and MRI of Adrenal Masses

Antonio Carlos A. Westphalen, MD; Bonnie N. Joe, MD, PhD


Appl Radiol. 2006;35(8):10-26. 

In This Article

Normal Adrenal Gland

The adrenal glands are small organs, weighing approximately 5.0 g each, on average, and measuring approximately 30.0 mm in width, 50.0 mm in length, and up to 10.0 mm in thickness. They have a linear "V’ or "Y’ shape and are located anterosuperiorly to the kidneys (Figures 1 and 2). The glands receive arterial supply from the superior, middle, and inferior suprarenal arteries, which are branches of the inferior phrenic arteries, abdominal aorta, and renal arteries, respectively. Venous drainage is through the suprarenal veins, into the inferior vena cava and left renal vein. On gross sections, the adrenal glands have a golden-yellow cortex and a reddish-brown medulla.[2]

Figure 1.

A 73-year-old man with esophageal cancer, normal appearance of the right adrenal gland on CT (arrow).

Figure 2.

A 59-year-old woman with lung cancer, normal appearance of the right adrenal gland on MRI (arrow).

One Gland, 2 Functions

Although the adrenal gland is considered a single organ, it carries out 2 distinct endocrine functions. The cortex is of mesodermal origin and is composed of 3 zones: zona reticularis, zona fasciculata, and zona glomerulosa.[2] The cortex produces steroid hormones, including aldosterone, cortisol, and androgens. The medulla derives from ectoderm (neural crest cells) and is responsible for the secretion of catecholamines (epinephrine and norepinephrine). The production of ≥1 of these substances by hyperfunctioning tumors results in clinical syndromes such as Cushing's or Addison's disease.[3,4]


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